JMIR Publications

ABSTRACT

Background:

The recent, widespread availability of augmented reality (AR) via smartphone offers an opportunity to translate cue exposure therapy for smoking cessation from the laboratory to the real world. Despite significant reductions in smoking rates in the last decade, approximately 13.7% of U.S. adults continue to smoke. Smoking-related cue exposure has demonstrated promise as an adjuvant therapy in the laboratory, but practical limitations have prevented its success in the real world. AR technology presents an innovative way to help overcome these limitations.

Objective:

To develop a smartphone app that presents smoking-related AR images for cue exposure. Smokers provided feedback on the images and reported on perceived urge to smoke, qualities of reality/co-existence, and general feedback about quality and functioning. The feedback was used to refine the AR images within the app.

Methods:

In collaboration with an AR design company, we developed 6 smoking-related images (cigarette, lighter, ashtray, lit cigarette in ashtray etc.) and 6 neutral images similar in size or complexity for comparison (pen, eraser, notebook, soda bottle with droplets etc.). Ten smokers completed a survey of demographic characteristics, smoking history and behavior, dependence on nicotine, motivation to quit smoking, and familiarity with AR technology. Then, participants viewed each AR image and provided Likert scale ratings on urge to smoke and reality/co-existence of the image into the scene. Participants were also queried with open-ended questions regarding features of the images.

Results:

Half of participants had some familiarity with AR prior to the laboratory visit. Although the sample was small, smokers reported significantly higher urge to smoke after viewing the smoking-related AR images (Median 4.58, SD=3.49) than the neutral images (Median 1.42, SD=3.01) (P=.03; d=.70). The average reality and co-existence ratings of the images did not differ between smoking-related and neutral images. Participants noted some areas of excellence (eg, details of the lit cigarette) and areas for improvement (eg, stability of images, lighting).

Conclusions:

The smoking AR images resulted in higher urge to smoke than the neutral AR images. Additionally, all images were generally perceived as being realistic and well-integrated. The feedback provided by participants suggests that AR images may indeed be useful to develop into an adjuvant therapy for smoking cessation. Future directions and next steps are discussed.